鲍曼不动杆菌耐药性变迁与临床抗生素选用偏好的关系

目的：探讨临床医生抗生素选用偏好对鲍曼不动杆菌(Ab)耐药性的影响，为临床治疗提供参考。方法:选择经细菌培养、Ab阳性的临床标本1 078株，根据耐药情况将分离出的Ab菌株分为449株多药耐药Ab组和437株非耐药Ab，分析临床医生选用碳青霉烯类抗生素和（或）β-内酰胺类+β-内酰胺酶抑制剂治疗非耐药Ab的选用偏好与A...

Relationship between changes of drug resistance of Acinetobacter baumannii strains and preferences of clinical antibiotics adoption

Objective To investigate the influence of the adoption preference in the clinical choice of antibiotics on drug resistance of Acinetobacter baumannii(Ab),and to provide references for clinical treatment.Methods 1 078 Ab-positive strains isolated from clinical specimens were divided into multi-drug resistance Ab straains(n=449) and non-drug resistance strins(n=437) based on drug resistance.The relationship between clinicians,preferences of choosing carbapenem antibiotics and(or) βlactam antibiotics adding β-lactamase inhibitor to treat non-drug resistance Ab and the changes of drug resistance of Ab strains was analyzed.Results There were 394 Ab strains in 2006,354 Ab strains in 2007,and 330 Ab strains in 2008.449 multi-drug resistance Ab strains contained 206 strains in 2006,124 strains in 2007,and 119 strains in 2008.In multi-drug resistance Ab group,the ratios of sensitivity to carbapenem antibiotics and adding β-lactamase inhibitor from 2006 to 2008 were 25.2%,50.8%,and 25.2%.The ratios only sensitive to carbapenem antibiotics from 2006 to 2008 were 68.0%,11.3%,and 2.5%;the ratios only sensitive to antibiotics adding β-lactamase inhibitor from 2006 to 2008 were 6.8%,37.9%,and 72.3%.437 non-drug resistance Ab strains contained 88 strains in 2006,230 strains in 2007,and 119 strains in 2008.The ratios of clinician's preference of choosing carbapenem antibiotics from 2006 to 2008 were 0%,9.3%,and 20.7%.The ratios of clinician's preference of choosing antibiotics adding β-lactamase inhibitor from 2006 to 2008 were 35.5%,38.4%,and 22.4%.With the increasing frequencies of using carbapenem antibiotics in non-drug resistance Ab from 2006 to 2008,the carbapenem resistance of Ab increased rapidly.From 2006 to 2007,with the slow increasing of choosing antibiotics adding β-lactamase inhibitor in non-drug resistance Ab infected patients,the drug resistance of Ab to adding β-lactamase inhibitor decreased obviously.In 2008, the frequencies of using antibiotics adding β-lactamase inhibitor in non-drug resistance Ab decreased,the sensitivity to antibiotics adding β-lactamase inhibitor increased twice in multi-drug resistance Ab.Conclusion The preferences of clinicial antibiotics adoption may influence the changes of drug resistance of Ab strains,but β-lactamase inhibitor maybe obviously suppress the production of drug resistance of Ab strains.